Robotic kidney transplantation: The Bakırköy experience

Abstract

Objective: Robotic kidney transplantation, first described by Hoznek and colleagues, and has been improved by investigators like Oberholzer and Menon. We realized the first robotic kidney transplant (RKT) in our clinic in December 2015. In this study, we aimed to present the first 15 cases we performed within 3 months. Materıal and methods:Starting from January 2016, we performed 15 RKTs in our hospital. Before surgery, the whole robotic procedure was thoroughly explained to the patients and their informed consents were taken. Results:We performed RKT in 7 male and 8 female patients. Mean patient age was 37.4±10.8 years. Mean body mass index of the patients was 22.6±3.35 kg/m². Mean preoperative creatinine and hemoglobin levels were 6.14±2.12 mg/dL and 10.04±1.64 g/dL, respectively. Mean operative time was 300.3±104.2 minutes. Mean warm ischemia and re-warming times were 1.9±0.54 minutes and 73.3±30.7 minutes, respectively. We did not need any necessity to switch to open surgery, and any intraoperative complication did not develop in any patient. Lymphocele which is one of the most frequently encountered complications was not observed in our series. Conclusion:We think that using a minimally invasive approach greater number of patients will be able to benefit from this treatment modality, and this important health issue may decrease significantly.

Robot-assisted Kidney Transplantation: The European Experience

“…Even though it has been confirmed by other authors that this technique is safe and effective [8,18], many concerns remain regarding local and possibly systemic complications related to the use of intraperitoneal cooling to maintain the graft at a constant low temperature. Tu gcu et al [19] reported paralytic ileus as a complication of the use of ice slush, and no ileus occurred when the amount of ice slush was decreased. The three cases of ileus (2.5%) that we observed could also have been caused by intraperitoneal ice cooling.…”

Robot‐assisted kidney transplantation: comparison of the first 40 cases of open vs robot‐assisted transplantations by a single surgeon

“…Since then, there have been various publications of RAKT series. Studies carried out by Tuğcu et al and Breda et al are two examples that deal with RAKT in general. However, to the best of our knowledge there may be few, if any, studies that have compared RAKT with OKT.…”

“…As described in detail previously , in the RAKT technique, the patient is placed in a 15–30 ° supine Trendelenburg position. A 5‐cm paraumbilical incision is made for the placement of a gel port.…”

“…KT first moved to an endoscopic approach with the application of laparoscopy to donor nephrectomy in the mid-1990s [6]. Now KT may be on the verge of a new endoscopic era, with the advent of robot-assisted kidney transplantation (RAKT), which is a new technique in minimally invasive urology that has been gaining in popularity in recent years [7][8][9][10][11].…”

Can robot‐assisted kidney transplantation provide higher quality of life than open kidney transplantation during the early postoperative period?

“…9 The RAKT technique was described by Hoznek et al and further developed by Oberholzer et al and Menon et al [10][11][12] Since then, favourable outcomes have been achieved in several transplant centres. [10][11][12]23,24 The European Robotic Urological Society (ERUS)-RAKT group has reported that RAKT is a safe and effective treatment option in the hands of surgeons experienced in robotic surgery and OKT. 25 In this study, they recommended cadaveric RAKT courses and mentor-guided surgery at the beginning of the learning curve.…”